Maternal and Fetal Outcomes in Systemic Lupus Erythematosus Pregnancies

医学 产科 羟基氯喹 怀孕 胎儿 小于胎龄 胎龄 不利影响 回顾性队列研究 活产 系统性红斑狼疮 疾病 内科学 2019年冠状病毒病(COVID-19) 遗传学 传染病(医学专业) 生物
作者
Yih Jia Poh,Irene Yuen Lin Yii,Lim Hee Goh,Hui Hua Li,Liying Yang,Hak Koon Tan,Julian Thumboo,Lay Kok Tan
出处
期刊:Annals Academy of Medicine Singapore [Academy of Medicine, Singapore]
卷期号:49 (12): 963-970 被引量:6
标识
DOI:10.47102/annals-acadmedsg.2020373
摘要

Abstract Introduction: To describe the maternal and fetal outcomes in systemic lupus erythematosus (SLE) pregnancies followed-up in a single tertiary referral centre. Methods: We performed a retrospective cohort study of 75 SLE pregnancies who were followed up in Singapore General Hospital over a 16-year period from 2000 to 2016. Adverse fetal and maternal outcomes including preterm delivery, miscarriages, fetal growth restriction, congenital heart block, neonatal lupus, pre-eclampsia and SLE flares were obtained from the medical records. Results: The mean age at conception was 32 years old (SD 3.8). The mean SLE disease duration was 5.9 years (SD 5.2). The majority (88%) had quiescent SLE disease activity at baseline. Most pregnancies resulted in a live birth (74.7%). The mean gestational age at birth was 37.4 weeks (SD 3.4). Adverse fetal outcomes occurred in 53.3%. Preterm delivery (33.9%), miscarriages (20%) and fetal growth restriction (17.3%) were the most frequent adverse fetal outcomes. There was 1 neonatal death and SLE flares occurred in a third (33%). In the subgroup of SLE pregnancies with antiphospholipid syndrome, there were higher SLE flare rates (40%) and adverse fetal outcomes occurred in 8 pregnancies (80%). There were no predictive factors identified for all adverse fetal and maternal outcomes. In the subgroup analysis of preterm delivery, anti-Ro (SS-A) antibody positivity and hydroxychloroquine treatment were associated with a lower risk of preterm delivery. Conclusion: Although the majority had quiescent SLE disease activity at baseline, SLE pregnancies were associated with high rates of adverse fetal and maternal outcomes. Keywords: Antiphospholipid syndrome, anti-La (SS-B) antibody, anti-Ro (SS-A) antibody, lupus nephritis
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